Provider Demographics
NPI:1790930683
Name:WALNUT NATURAL HEALTH CENTER
Entity Type:Organization
Organization Name:WALNUT NATURAL HEALTH CENTER
Other - Org Name:WU CHIROPRACTIC CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANLI
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DC, L AC
Authorized Official - Phone:626-839-8578
Mailing Address - Street 1:18710 AMAR RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4571
Mailing Address - Country:US
Mailing Address - Phone:626-839-8578
Mailing Address - Fax:626-839-7001
Practice Address - Street 1:18710 AMAR RD
Practice Address - Street 2:SUITE C
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4571
Practice Address - Country:US
Practice Address - Phone:626-839-8578
Practice Address - Fax:626-839-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30187111N00000X
CAAC9113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty